This blog documents the journey of Marla Crider, a 60 year-old travel professional from Little Rock, Arkansas, as she battles a breast cancer called invasive ductal carcinoma (stage 3). From the moment of her diagnosis, she chronicles her experience. Be forewarned this blog may provide a raw glimpse into the author’s psyche and ability to deal with a life threatening challenge. Hopefully, her honesty and humor will provide advice and help to others who find themselves in a crusade of their own.

Tuesday, October 8, 2013

Dr. Suzanne Klimberg: The Surgeon Schedules the Surgery

The aches and pains from my final chemo treatment were
causing some discomfort when I reported for my appointment a few days later
with nationally known breast surgeon, Dr. Suzanne Klimberg. I nicknamed the
good doctor “Picasso” because of her penchant for drawing imaginary incision
lines on my breasts as a way to explain the upcoming mastectomy surgery.

Breast surgeon, Dr. Suzanne Klimberg.

It isn't unusual for Dr. Klimberg to
have several medical students shadowing her every move and hanging on her every
word.These fresh-faced wannabes are
eager to learn from the best in hopes of one day using their knowledge to
create new, streamlined surgical techniques or, perhaps, to develop a vaccine that
could eradicate cancer all together.There’s
no better reason to be a patient at the University of Arkansas
for Medical Sciences – the state’s only teaching hospital – because you see the
future of medicine in every young face wearing a lab coat and can’t help but
think about the possibilities.

Don, an accomplished surgeon himself, accompanied me to my
appointment to ask questions about the surgery and interpret the answers.We had only been in the exam room a few
minutes when Dr. Klimberg’s nurse came in to inquire about my chemo regimen and
to confirm the date of my last treatment.She surprised me when she requested to examine my breasts.The nurse took a black pen out of her pocket
and drew a circle very near the right nipple where she felt evidence of the remaining
cancer (Hmmmm.Apparently, everyone in
the Klimberg clinic is an artist and my breast seems to be their favorite canvas). She explained
that she was marking the area for Dr. Klimberg to evaluate.

A few minutes later Dr. K entered the room with a med
student at her side.The doctor
introduced her protégé to Don and me as one of her brightest scholars. The
fresh-faced young woman blushed at the compliment. There were now a total of
five people in the small cubicle, yet no one seemed to notice (or care) that I
was lying bare-breasted on the exam table. It was all in a day’s work for them.
I learned quickly after my first visit to the UAMS Cancer Institute six months
ago that my breasts were no longer just mine.I had to relinquish custody of “the girls” to my medical team in an
effort to rid the right one of cancer. Dr.
K moved to the right side of the exam table and the med student was on the
left.The RN was in the background
making notes.

Dr. Klimberg immediately zeroed in on the black circle made
by the nurse.She palpitated my right
breast, then the left, and moved back to the right breast where she found what
was left of the once very large mass. She instructed the med student to feel the small tumor, as well.I was beginning to
get a little nervous listening to the two of them bantering back and forth
until Dr. Klimberg explained that her concern was not the small remnant of the
tumor but rather the close proximity to the nipple. She was uneasy about
saving it. “Do you like your nipples?” she inquired.“Heck, yea,” I replied rather shocked at her
question.“Why wouldn’t I like
them?We’ve been close pals for 60
years,” I stated rather matter-of-factly. “Well, in case you didn’t or should I
not be able to save the blood supply to the right nipple, I want to assure you
that Dr. Yuen (my plastic surgeon) makes a very nice nipple.”(It’s comforting to know that my
reconstruction surgeon is known for his nipple-making.) No doubt, that was the
strangest conversation I have ever had with anyone.

I asked Dr. K if she was still planning to do the new
surgical technique created just for me in an effort to salvage more tissue and
skin for the breast reconstruction that had been delayed for six months due to
my diabetes.“Absolutely,” she remarked.
Dr. K, or should I call her Dr. Picasso, took the black pen out of her lab coat
and started drawing imaginary incision lines(Here we go again, I thought. It's “show and
tell” time).The med student listened
intently as Dr. Klimberg explained the procedure to her, as well as Don.The
two surgeons in the room – Dr. K and my significant other – began to throw
technical terms around until I reminded them that the bare-breasted patient
didn’t understand a thing they were saying.I interrupted their physician bonding moment and inquired if Dr. K had
decided on a name for the new procedure. “Breast over pants,” my surgeon said
with a straight face.Interestingly, Don
knew exactly why she chose it.He
enlightened me that there is a hernia repair called “vest over pants” and it
all had to do with making a flap that restores blood flow to the impacted area.

Dr. Klimberg shared with me that several of her students
were vying to assist her in surgery to observe this new technique. I asked how she
would determine which young surgeon-to-be would be in the operating room.“It all comes down to which one has the best
bribe,” quipped my brilliant body artist.

Dr. Klimberg’s nurse jumped in and asked if she was really
supposed to put the name “breast over pants” on the surgery orders because the
medical staff would question it, having never heard of such a procedure.“Even more reason to do it,” Dr. K responded
with a twinkle in her eye.After sitting
up on the exam table and covering my bareness with an unfashionable gown, the
nurse informed me that I was on the surgery schedule for Friday, October
11.“Do you know if it will be morning
or afternoon?” I asked.Dr. K jumped
in and said the team usually reserves the early morning surgeries for old
people and diabetics and I qualified for both.I couldn’t help but laugh out loud at her comment as did the others in
the room.The nurse handed me several
pages of instructions and told me to return for a pre-surgery consult with Dr.
Klimberg on October 10, followed by a meeting with the assigned anesthesiologist.

“It’s really going to happen,” I remarked to Don as we
exited the cancer institute.“I just
hope I’m emotionally prepared when the date rolls around.”

“I have no doubt that you will handle the surgery with the
same determination that you did the chemotherapy,” he said.From his lips to God’s ears…

About Me

Marla Crider, a 60 year-old travel professional from Little
Rock, Arkansas, is blogging her battle with invasive ductal carcinoma or in layman’s terms –
breast cancer. From the moment she discovers the lurking lump in her right
breast, she apprehensively chronicles her thoughts and emotions for public
scrutiny. Be forewarned that these postings may provide a raw glimpse into the
author’s psyche and ability to deal with a life threatening challenge. Hopefully,
Marla’s honesty, humor, and prose approach of dealing with her diagnosis and
subsequent treatment plan will help others who find themselves in a crusade of
their own. You may follow her journey here: www.MarlaCrider.com . Marla has lived and worked previously in Fayetteville, Arkansas and Hot Springs, Arkansas.

Invasive Ductal Carcinoma: What is it?

Invasive ductal carcinoma (IDC) is the most common form of invasive breast cancer. It accounts for 80% of breast cancer incidence upon diagnosis, according to statistics from the U.S. in 2004. On a mammogram, it is usually visualized as a mass with fine spikes radiating from the edges. On physical examination, the lump usually feels much harder or firmer than benign breast lesions such as fibroadenoma. On microscopic examination, the cancerous cells invade and replace the surrounding normal tissues.

Mammograms

Breast tissue is composed of fatty (nondense) tissue and connective (dense) tissue. Radiologists use a grading system to describe the density of breast tissue based on the proportion of fat to connective tissue. There are four levels of density that are detected by mammograms: Level 1 (a very fatty breast), level 2 (fatty tissue makes up more than 50 percent of breast), level 3 (dense tissue makes up more than 50 percent of the breast) and level 4 (a very dense breast with very little fat). Click the image above for more information from the Mayo Clinic.

Get a Breast Cancer Screening

Click map to find a screening site near you.

All original content copyright (c) 2013, Marla F. Crider and marlacrider.com. You are free to share (copy, distribute and transmit) content from this site with attribution to marlacrider.com.